Analitik Hiyerarşi Süreci ile Kullanıcı Talebine Dayalı Sağlık Tesisi Yer Seçimi Modeli
Year 2022,
Volume: 14 Issue: Özel Sayı, 221 - 244, 31.12.2022
Gökçen Gürsoy
,
Mehmet Ali Yüzer
Abstract
Kentsel nüfusun artışı, yapılı çevrenin hızla büyümesi ve erişilebilirlik gibi unsurlar, kullanıcıların kamu tarafından sunulan sağlık hizmetine erişimini zorlaştırmaktadır. Mekânsal etkenler dışında ayrıca kullanıcıların demografik ve ekonomik yapıları, sunulan hizmetlerin kapsamı gibi diğer faktörler sağlık hizmetine erişimi etkilemekte ve kullanıcıların sağlık sektöründe hizmet veren kurum veya kuruluşlardan hizmet alma seçeneklerini farklılaştırmaktadır. Bu çalışma kentsel alanda yer alacak sağlık tesislerinin yer seçimini etkileyecek faktörlerin belirlenmesi, hastane talebinin girdilerinin belirlenmesi ve geleceğe yönelik sağlık sisteminin mekânsal dağılımının nasıl olması gerektiğine dair öngörülere erişmeye odaklanmaktadır. Bu kapsamda yataklı tedavi hizmeti veren genel kamu hastanesi statüsündeki tesisler için mevcut sağlık mevzuatı ve Sağlık Bakanlığı’nın belirlediği kurallar çerçevesinde hipotetik bir tesis hiyerarşisi kurgulanmıştır. Hiyerarşide yer alan tesislerin yer seçimleri için talep ölçümü demografik, ekonomik ve mekânsal olmak üzere üç konuda detaylandırılmıştır. Bu çalışmada, farklı temalarda kurgulanan talep ölçümlerinin göreli önem derecelerini tespit etmek için “Analitik Hiyerarşi Süreci” yönteminden yararlanılmıştır. Bu makalede, yaş ve cinsiyete, özel sağlık ve tamamlayıcı sigorta sahipliğine ve ulaşıma bağlı talep ölçümleri neticesinde yataklı tedavi hizmeti veren genel hastaneler için geliştirilen hiyerarşik yer seçimi modelinin genel kurgusu açıklanacaktır.
References
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- Delamater PL, Messina JP, Shortridge AM, Grady SC. (2012). Measuring geographic access to health care: raster and network-based methods. Int J Health Geogr. 11(1):15. doi:10.1186/1476-072X-11-15
- Dökmeci, V. (1977). A quantitative model to plan regional health facility systems. Management Science, 24(4), 411-419. doi: 10.1287/mnsc.24.4.411
- El-Geneidy, A., Levinson, D., Diab, E., Boisjoly, G., Verbich, D. ve Loong, C. (2016). The cost of equity: Assessing transit accessibility and social disparity using total travel cost. Transportation Research Part A: Policy and Practice, 91, 302-316. doi:10.1016/j.tra.2016.07.003
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- Geurs, K. T., ve van Wee, B. (2004). Accessibility evaluation of land-use and transport strategies: review and research directions. Journal of Transport Geography, 12(2), 127–140. doi:10.1016/j.jtrangeo.2003.10.005
- Gruen, R. L., Elliott, J. H., Nolan, M. L., Lawton, P. D., Parkhill, A., McLaren, C. J. ve Lavis, J. N. (2008). Sustainability science: an integrated approach for health-programme planning. The Lancet, 372(9649), 1579-1589. doi:10.1016/S0140-6736(08)61659-1
- Guagliardo, M. F. (2004). Spatial accessibility of primary care: concepts, methods and challenges. International Journal of Health Geographics, 3(1), 3. doi:10.1186/1476-072x-3-3
- Gulliford, M., Figueroa-Munoz, J., Morgan, M., Hughes, D., Gibson, B., Beech, R. ve Hudson, M. (2002). What does “access to health care” mean? Journal of Health Services Research & Policy, 7(3), 186–188. doi:10.1258/135581902760082517
- Hansen, W. G. (1959). How accessibility shapes land use. Journal of the American Institute of Planners, 25(2), 73-76. doi:10.1080/01944365908978307
- Hastane Rolleri. (2009). Ankara: Sağlık Bakanlığı. Erişim adresi: https://khgmsaglikhizmetleridb.saglik.gov.tr/TR-81722/hastane-rolleri.html
- Llewelyn-Davies, R., Macaulay, H. M. C. ve World Health Organization. (1966). Hospital planning and administration. World Health Organization Monograph Series No. 54.
- Paköz, M. Z. (2014). Sağlık Hizmetlerine Erişim ve Hastane Yer Seçimi: İstanbul Örneği (Doktora Tezi, İstanbul Teknik Üniversitesi Fen Bilimleri Enstitüsü). Erişim adresi: https://polen.itu.edu.tr/items/be0e4443-256d-4f8b-a7e9-b34136f88666
- Paköz, M. Z. ve Yüzer, M. A. (2014). Determinants of Access to Healthcare: A Survey in Istanbul. 54th Congress of the European Regional Science.
- Pantzartzis, E., Edum-Fotwe, F. T. ve Price, A. D. (2017). Sustainable healthcare facilities: Reconciling bed capacity and local needs. International Journal of Sustainable Built Environment, 6(1), 54-68. doi:10.1016/j.ijsbe.2017.01.003
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- Sağlık Hizmet Sunucularının Basamaklandırılmasına Dair Yönetmelik (2022, 10 Şubat). Resmi Gazete (Sayı: 31746). Erişim adresi: https://www.resmigazete.gov.tr/eskiler/2022/02/20220210-1.htm
- Schultz, G. P. (1970). The logic of health care facility planning. Socio-Economic Planning Sciences, 4(3), 383-393.
Serra, D. ve Marianov, V. (2004). New trends in public facility location modeling. SSRN Electronic Journal. doi:10.2139/ssrn.563843
- Thisse, J. F. ve Wildasin, D. E. (1992). Public facility location and urban spatial structure: equilibrium and welfare analysis. Journal of Public Economics, 48(1), 83-118. doi:10.1016/0047-2727(92)90043-f
- Vaidya, O. S. ve Kumar, S. (2006). Analytic hierarchy process: An overview of applications. European Journal of Operational Research, 169(1), 1-29. doi:10.1016/j.ejor.2004.04.028
- White, A. N. (1979). Accessibility and public facility location. Economic Geography, 55(1), 18. doi:10.2307/142730
- WHO, Hospital beds (per 10 000 population). (2018). Erişim adresi: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/hospital-beds-(per-10-000-population)
Health Facility Location Model Based on User Demand with Analytic Hierarchy Process
Year 2022,
Volume: 14 Issue: Özel Sayı, 221 - 244, 31.12.2022
Gökçen Gürsoy
,
Mehmet Ali Yüzer
Abstract
Increase in population, rapid development of built environment and accessibility make access to public services difficult for users. Apart from spatial factors, demographic and economic structure of the users and the scope of the services affect the access to health services through diversifying the getting service options from the health institutions. This study focuses on determining the factors that affect the location of the health facilities, designating the inputs of the hospital demand measurement, and estimating the optimum spatial distribution of the health facilities. In this context, a hypothetical facility hierarchy has been built within the framework of the current health legislation and norms designated by the Ministry of Health for the facilities in the status of general public hospitals that provide inpatient treatment. Hospital demand measurement is detailed in three themes; demographic, economic and spatial. The “Analytic Hierarchy Process” method was used to decide weighting of the hospital demand types through designating the relative importance of the location criteria. In this study, the hierarchic health facility location model that includes demand types of age and gender based, private health insurance ownership based and transportation based is presented.
References
- Anis, S., Di Febbraro, A. ve Sacco, N. (2021). A methodological framework for determination of public transport accessibility index. Smart City Symposium Prague (SCSP) (pp. 1-6). IEEE. doi:10.1109/SCSP52043.2021.9447403
- Barker, C. (1996). The health care policy process. SAGE Publications.
- Calvo, A. B. ve Marks, D. H. (1973). Location of health care facilities: an analytical approach. Socio-Economic Planning Sciences, 7(5), 407-422. doi:10.1016/0038-0121(73)90039-6
- Christaller, W. (1966). Central places in southern Germany (Vol. 10). Prentice-Hall.
- Delamater PL, Messina JP, Shortridge AM, Grady SC. (2012). Measuring geographic access to health care: raster and network-based methods. Int J Health Geogr. 11(1):15. doi:10.1186/1476-072X-11-15
- Dökmeci, V. (1977). A quantitative model to plan regional health facility systems. Management Science, 24(4), 411-419. doi: 10.1287/mnsc.24.4.411
- El-Geneidy, A., Levinson, D., Diab, E., Boisjoly, G., Verbich, D. ve Loong, C. (2016). The cost of equity: Assessing transit accessibility and social disparity using total travel cost. Transportation Research Part A: Policy and Practice, 91, 302-316. doi:10.1016/j.tra.2016.07.003
- Flores, L. J. Y., Tonato, R. R., dela Paz, G. A. ve Ulep, V. G. (2021). Optimizing health facility location for universal health care: A case study from the Philippines. PloS one, 16(9).
- Geurs, K. T., ve van Wee, B. (2004). Accessibility evaluation of land-use and transport strategies: review and research directions. Journal of Transport Geography, 12(2), 127–140. doi:10.1016/j.jtrangeo.2003.10.005
- Gruen, R. L., Elliott, J. H., Nolan, M. L., Lawton, P. D., Parkhill, A., McLaren, C. J. ve Lavis, J. N. (2008). Sustainability science: an integrated approach for health-programme planning. The Lancet, 372(9649), 1579-1589. doi:10.1016/S0140-6736(08)61659-1
- Guagliardo, M. F. (2004). Spatial accessibility of primary care: concepts, methods and challenges. International Journal of Health Geographics, 3(1), 3. doi:10.1186/1476-072x-3-3
- Gulliford, M., Figueroa-Munoz, J., Morgan, M., Hughes, D., Gibson, B., Beech, R. ve Hudson, M. (2002). What does “access to health care” mean? Journal of Health Services Research & Policy, 7(3), 186–188. doi:10.1258/135581902760082517
- Hansen, W. G. (1959). How accessibility shapes land use. Journal of the American Institute of Planners, 25(2), 73-76. doi:10.1080/01944365908978307
- Hastane Rolleri. (2009). Ankara: Sağlık Bakanlığı. Erişim adresi: https://khgmsaglikhizmetleridb.saglik.gov.tr/TR-81722/hastane-rolleri.html
- Llewelyn-Davies, R., Macaulay, H. M. C. ve World Health Organization. (1966). Hospital planning and administration. World Health Organization Monograph Series No. 54.
- Paköz, M. Z. (2014). Sağlık Hizmetlerine Erişim ve Hastane Yer Seçimi: İstanbul Örneği (Doktora Tezi, İstanbul Teknik Üniversitesi Fen Bilimleri Enstitüsü). Erişim adresi: https://polen.itu.edu.tr/items/be0e4443-256d-4f8b-a7e9-b34136f88666
- Paköz, M. Z. ve Yüzer, M. A. (2014). Determinants of Access to Healthcare: A Survey in Istanbul. 54th Congress of the European Regional Science.
- Pantzartzis, E., Edum-Fotwe, F. T. ve Price, A. D. (2017). Sustainable healthcare facilities: Reconciling bed capacity and local needs. International Journal of Sustainable Built Environment, 6(1), 54-68. doi:10.1016/j.ijsbe.2017.01.003
- Saaty, T. L. (1977). A scaling method for priorities in hierarchical structures. Journal of Mathematical Psychology, 15(3), 234–281. doi:10.1016/0022-2496(77)90033-5
- Saaty, T. L. (1990). An exposition of the AHP in reply to the paper “remarks on the analytic hierarchy process”. Management Science, 36(3), 259-268. doi:10.1287/mnsc.36.3.259
- Saaty, T. L. (2005). Making and validating complex decisions with the AHP/ANP. Journal of Systems Science and Systems Engineering, 14(1), 1-36. doi:10.1007/s11518-006-0179-6
- Sağlık Bakanlığı, Sağlık İstatistikleri Yıllığı 2019. (2021). Erişim adresi: https://sbsgm.saglik.gov.tr/TR,82338/saglik-istatistikleri-yilligi-2019-yayinlanmistir.html
- Sağlık Hizmet Sunucularının Basamaklandırılmasına Dair Yönetmelik (2022, 10 Şubat). Resmi Gazete (Sayı: 31746). Erişim adresi: https://www.resmigazete.gov.tr/eskiler/2022/02/20220210-1.htm
- Schultz, G. P. (1970). The logic of health care facility planning. Socio-Economic Planning Sciences, 4(3), 383-393.
Serra, D. ve Marianov, V. (2004). New trends in public facility location modeling. SSRN Electronic Journal. doi:10.2139/ssrn.563843
- Thisse, J. F. ve Wildasin, D. E. (1992). Public facility location and urban spatial structure: equilibrium and welfare analysis. Journal of Public Economics, 48(1), 83-118. doi:10.1016/0047-2727(92)90043-f
- Vaidya, O. S. ve Kumar, S. (2006). Analytic hierarchy process: An overview of applications. European Journal of Operational Research, 169(1), 1-29. doi:10.1016/j.ejor.2004.04.028
- White, A. N. (1979). Accessibility and public facility location. Economic Geography, 55(1), 18. doi:10.2307/142730
- WHO, Hospital beds (per 10 000 population). (2018). Erişim adresi: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/hospital-beds-(per-10-000-population)